Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2023
Long-term cost-effectiveness of matrix-associated chondrocyte implantation in the German health care system: a discrete event simulation.
Cartilage defects in the knee can be caused by injury, various types of arthritis, or degeneration. As a long-term consequence of cartilage defects, osteoarthritis can develop over time, often leading to the need for a total knee replacement (TKR). The treatment alternatives of chondral defects include, among others, microfracture, and matrix-associated autologous chondrocyte implantation (M-ACI). The purpose of this study was to determine cost-effectiveness of M-ACI in Germany with available mid- and long-term outcome data, with special focus on the avoidance of TKR. ⋯ M-ACI is projected to be a highly cost-effective treatment for chondral defects of the knee in the German healthcare setting.
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Arch Orthop Trauma Surg · Mar 2023
Novel metaphyseal porous titanium cones allow favorable outcomes in revision total knee arthroplasty.
Loosening and migration are common modes of aseptic failure following complex revision total knee arthroplasty (rTKA). Metaphyseal cones allow surgeons to negotiate the loss of femoral and tibial bone stock while obtaining stable bony fixation. This study examines the mid-term functional and radiographic outcomes in patients undergoing rTKA utilizing a novel metaphyseal cone system with stems of variable length and fixation methods. ⋯ IV, case series.
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Arch Orthop Trauma Surg · Mar 2023
Relevant landmarks to navigate the suture locations for the arthroscopic triangular fibrocartilage complex foveal reattachment.
Key step of arthroscopic triangular fibrocartilage complex (TFCC) foveal reattachment is to suture dorsal and palmar deep components of radioulnar ligaments (RULs) to the fovea of ulnar head to ensure distal radioulnar joint stability. However, the deep components are covered and cannot be identified arthroscopically from standard radiocarpal joint view. Suturing sites described in previous studies have not been proved gasping of the deep components. The purpose of this study was to investigate our TFCC suture locations using relevant landmarks on securing the RULs' deep components for arthroscopic TFCC foveal reattachment. ⋯ We determined the relevant anatomical landmarks to navigate the TFCC suture locations, which reliably secure the deep components of the radioulnar ligaments for the arthroscopic TFCC foveal reattachment.
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Arch Orthop Trauma Surg · Mar 2023
Histopathological assessment of a two-stage reconstructive procedure of the infected Charcot foot.
Charcot neuropathic osteoarthropathy (CN) can be complicated by osteomyelitis (OM). Surgery is a standard procedure to treat OM including debridement and interposition of antibiotic-loaded cement (ABLC) spacer. The course of CN and OM was investigated on a histopathological level. ⋯ CN activity could be reduced by surgery. It can be suggested that neuroosteoarthropathic activity measured by HCS is triggered by OM.
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Arch Orthop Trauma Surg · Mar 2023
Influence of lateral hinge fractures on biplanar medial closing-wedge distal femoral osteotomy for valgus knee: a new classification of lateral hinge fracture.
The purpose of this study was to examine the influence of lateral hinge fractures in medial closing-wedge distal femoral osteotomy (MCWDFO) on bone union. ⋯ There is a very high risk of hinge fracture in patients undergoing MCWDFO. Hinge fractures often lead to slow healing and a loss of correction. We recommend the endpoint of the distal lateral cortex of the femur as the ideal hinge point for the prevention of hinge fractures. Bone union is obtained slowly in even all hinge fracture cases without revision surgery. Consequently, surgical results are not affected by the occurrence of hinge fracture at 1 year.